Individual
MRS. TAMMY BRADFORD PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CSR, LDN
Contact information
Practice address
711 WOOD ST, MONROE, LA 71201-7549
(318) 323-8847
Mailing address
175 COMANCHE TRL, WEST MONROE, LA 71291-8105
(318) 396-9293
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
578
LA
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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